The Cycle of Alcohol Addiction National Institute on Alcohol Abuse and Alcoholism NIAAA

Significant advancements have been made in understanding the neurobiological underpinnings and environmental factors that influence motivation to drink as well as the consequences of excessive alcohol use. Given the diverse and widespread neuroadaptive changes that are set in motion as a consequence of chronic alcohol exposure and withdrawal, it perhaps is not surprising that no single pharmacological agent has proven to be fully successful in the treatment of alcoholism. Alcohol is rapidly absorbed in the gut and reaches the brain soon after drinking.

How we reviewed this article:

  1. When is it common in society, it can be hard to tell the difference between someone who likes to have a few drinks now and then and someone with a real problem.
  2. This section provides an overview of the issues for each special population.
  3. Sensitization resulting from repeated withdrawal cycles and leading to both more severe and more persistent symptoms therefore may constitute a significant motivational factor that underlies increased risk for relapse (Becker 1998, 1999).
  4. Harmful drinking in men varied from 5% in the East Midlands to 11% in Yorkshire and Humber, and in women from 2% in the East of England to 7% in Yorkshire and Humber.

Services that are involved with those who misuse alcohol fit into a wider context of safeguarding young people from harm and need to work to ensure that the rights of children, young people and their parents are respected. Local protocols between alcohol treatment services and local safeguarding and family services determine the specific actions to be taken (Department for Children, Schools and Families, National Treatment Agency & Department of Health, 2009). This latter finding suggests that elevated alcohol self-administration does not merely result from long-term alcohol exposure per se, but rather that repeated withdrawal experiences underlie enhanced motivation for alcohol seeking/consumption. This effect apparently was specific to alcohol because repeated chronic alcohol exposure and withdrawal experience did not produce alterations in the animals’ consumption of a sugar solution (Becker and Lopez 2004).


In addition to physical signs of withdrawal, a constellation of symptoms contributing to a state of distress and psychological discomfort constitute a significant component of the withdrawal syndrome (Anton and Becker 1995; Roelofs 1985; Schuckit et al. 1998). Many of these signs and symptoms, including those that reflect a negative-affect state (e.g., anxiety, distress, and anhedonia) also have been demonstrated in animal studies involving various models of dependence (Becker 2000). Regardless of the type of support system, it’s helpful to get involved in at least one when getting sober.

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Several terms including ‘alcoholism’, ‘alcohol addiction’, ‘alcohol abuse’ and ‘problem drinking’ have been used in the past to describe disorders related to alcohol consumption. However, ‘alcohol dependence’ and ‘harmful alcohol use’ are used throughout this guideline to be consistent with WHO’s International Classification of Mental Disorders, 10th Revision (WHO, 1992). Whilst the government benzodiazepines detox northern california drug alcohol rehab and Royal Colleges’ definitions of harmful drinking and risk levels of alcohol consumption provide useful benchmarks to estimate the prevalence of alcohol-use disorders in the general population and monitor trends over time, they have a number of limitations. This is particularly apparent when examining an individual’s risk of alcohol-related harm at a given level of alcohol consumption.

Nevertheless, many will require access to specialist treatment by virtue of having more severe or chronic alcohol problems, or a higher level of complications of their drinking (for example, social isolation, psychiatric comorbidity and severe alcohol withdrawal). Alcohol dependence is thought to represent a persistent dysfunctional (i.e., allostatic) state in which the organism is ill-equipped to exert appropriate behavioral control over alcohol drinking. Although currently few treatments are available for tackling this significant health problem and providing relief for those suffering from the disease, there is hope.

To stop drinking alcohol, you first need to understand your relationship with drinking. From there, you may need social support, consistent self-care, and new routines that can help redirect your mind. Understanding the available treatment options—from behavioral therapies and medications to mutual-support groups—is the first step. The important thing is to remain engaged in whatever method you choose.

Because denial is common, you may feel like you don’t have a problem with drinking. You might not recognize how much you drink or how many problems in your life are related to alcohol use. Listen to relatives, friends or co-workers when they ask you to examine your drinking habits or crack addiction symptoms and treatment to seek help. Consider talking with someone who has had a problem with drinking but has stopped. His team is collaborating with Mass General’s Research Patient Data Registry to obtain de-identified patient records, which they plan to review for instances of stigmatizing language.

For example, the risk of developing breast cancer increases in a linear way, in which even small amounts of alcohol increase risk. With alcoholic liver disease the risk is curvilinear, with harm increasing more steeply with increasing alcohol consumption. In the case of cardiovascular disease a modest beneficial effect has been reported with moderate amounts of alcohol, although recent research suggests this effect may have been overestimated (Ofori-Adjei et al., 2007). During pregnancy alcohol can cause harm to the foetus, which can cause prematurity, stillbirth and the developmental disorder fetal alcohol syndrome.

This is of particular concern because alcohol presents particularly serious consequences in young people due to a higher level of vulnerability to the adverse effects of alcohol. Heavy drinking in adolescence can affect brain development and has a higher risk of organ damage in the developing body (Brown et al., 2008). All of this points to the importance of addressing the needs of family members of people who misuse alcohol. This includes the need for specialist treatment services to assess the impact of the individual’s drinking on family members and the need to ensure the safety of children living with people who misuse alcohol. There is no single factor that accounts for the variation in individual risk of developing alcohol-use disorders. The evidence suggests that harmful alcohol use and ayahuasca have a wide range of causal factors, some of which interact with each other to increase risk.

Examples of behavioral treatments are brief interventions and reinforcement approaches, treatments that build motivation and teach skills for coping and preventing a return to drinking, and mindfulness-based therapies. “The steps we are recommending should not only help to align clinical practice with sound language guidelines, but also foster a more empathetic and supportive healthcare environment for patients,” he said. Based on clinical experience, many health providers believe that support from friends and family members is important in overcoming alcohol problems. But friends and family may feel unsure about how best to provide the support needed.

Family members of people who are alcohol dependent have high rates of psychiatric morbidity, and growing up with someone who misuses alcohol increases the likelihood of teenagers taking up alcohol early and developing alcohol problems themselves (Latendresse et al., 2010). The adverse effects of alcohol dependence on family members are considerable. Marriages where one or both partners have an alcohol problem are twice as likely to end in divorce as those in which alcohol is not a problem. Nearly a million children live with one or more parents who misuse alcohol and 6% of adults report having grown up in such a family. Alcohol is implicated in a high proportion of cases of child neglect and abuse, and heavy drinking was identified as a factor in 50% of child protection cases (Orford et al., 2005).

There are also other support groups that don’t follow the 12-step model, such as SMART Recovery and Sober Recovery. More resources for a variety of healthcare professionals can be found in the Additional Links for Patient Care. Active participation in a mutual support group can benefit many people as well.28 Groups vary widely in beliefs and demographics, so advise patients who are interested in joining a group to try different options to find a good fit. In addition to widely recognized 12-step programs with spiritual components such as AA, a number of secular groups promote abstinence as well, such as SMART Recovery, LifeRing, Women for Sobriety, Secular Organizations for Sobriety, and Secular AA (see Resources, below, for links). The CAGE questionnaire, the name of which is an acronym of its four questions, is a widely used method of screening for alcohol dependence.